Educating coders and clinical documentation improvement (CDI) specialists on CMS claims-based measures is essential in today's value-based payment environment. Empowered with an understanding of measure specifications and risk adjustment methodologies, a strong CDI program can effectively address opportunities to improve quality profiles and associated hospital revenue.
In the first article in this series, we provided an introduction and overview of the PSI 90 measure, which is included in two CMS pay-for-performance programs. Because PSI 90 is a claims-based measure, performance is largely determined by ICD-9-CM codes on the claims.
Throughout the years, this column has focused on the important role the electronic document management system (EDMS) plays as the official legal health record (LHR) within a healthcare organization, and especially as a critical workflow tool for the HIM department. I am always surprised to hear that there are still some facilities that haven't figured this out and purchased an EDMS.
It's a prevailing trend?HIM directors and managers are overworked and underpaid. The results of MRB's 2015 HIM director and manager salary survey shows this trend remains firmly in place, although it does indicate these professionals' annual earnings have seen a slight uptick.
The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) have announced the release of two proposed rules designed to improve care delivery and experience and to enhance the sharing of electronic health information.
It has been a long time since The Joint Commission has published frequently asked questions (FAQ), which serve as a great resource for clarification of standards and elements of performance. Generally, FAQs originate with questions from the field that continue to be asked over time.
Last month, we laid the foundation to promote successful engagement of the coding and clinical documentation improvement teams in PSI 90 performance improvement efforts.
Incentives posed by the Institute for Healthcare Improvement's Triple Aim Initiative and value-based purchasing emphasize treating the whole person to include preventive, medical, dental, postacute, community, mental health, and addiction services.
As required by The Joint Commission, a board of directors should regularly assess its performance, appropriateness of board and committee processes and charter fulfillment, adequacy of meeting structures and goals, communication with management, and other governance structures and activities. Generally, boards and their committees complete this assessment through self-surveys, internal audits, or collection of results as performed by legal services. Assessment results can lead to changes in board processes, with the goal of adapting to changing risks and environmental requirements, and improvements in governance.
